Gambaran pengetahuan, sikap, dan praktik ibu balita terhadap penatalaksanaan diare pada anak balita di wilayah kerja Puskesmas Abang 1

Latar Belakang: Diare merupakan salah satu permasalahan kesehatan dunia yang menjadi penyebab utama kedua kematian anak dibawah lima tahun. Diare dan gastroenteritis dengan penyebab infeksi juga ditemukan masih termasuk ke dalam 10 besar penyakit dengan kunjungan terbanyak di Puskesmas Abang I, Karangasem. Edukasi kesehatan mengenai diare pada balita serta penanganannya penting untuk keefektifan penatalaksanaan kasus diare. Berdasarkan survei singkat yang dilakukan pada 10 orang ibu balita terkait dengan penanganan diare di rumah didapatkan bahwa sebagian besar (70%) ibu balita memberikan penanganan yang kurang tepat. Hal ini menunjukkan kecenderungan perilaku yang kurang tepat dalam penatalaksanaan diare di rumah.

Metode:  Penelitian ini merupakan studi deskriptif cross sectional dengan melibatkan 62 subjek penelitian yang merupakan ibu balita di wilayah kerja Puskesmas Abang I. Penelitian ini dilakukan bertujuan untuk mengetahui gambaran pengetahuan, sikap, dan praktik ibu balita dalam penatalaksanaan diare pada anak balita di wilayah kerja Puskesmas Abang I. Penelitian ini menggunakan metode purposive sampling untuk memilih tiga desa yang berada di wilayah kerja Puskesmas Abang I dan pengambilan sampel dilakukan dengan snowballing method. Cara pengumpulan data pada penelitian ini dengan melakukan wawancara berbasis kuesioner.

Hasil: Pada penelitian ini didapatkan gambaran pengetahuan mengenai diare pada balita mayoritas dalam kategori kurang (91,9%).

Simpulan: ibu balita memiliki pengetahuan kurang terkait penatalaksanaan diare pada balita, dimana sebagian besar ibu balita masih merespon negatif dalam penanganan awal saat anak mengalami buang air besar lebih encer dari biasanya serta penanganan diare cukup dengan oralit saja. Selain itu, sebagian besar ibu balita juga masih memiliki praktik yang kurang tepat terkait penggunaan obat tradisional dan pemberian teh manis pada balita dengan diare.

Gambaran evaluasi tingkat nyeri pasien pasca operasi radang usus buntu dengan bedah terbuka dan laparoskopi di Rumah Sakit Umum Pusat Sanglah Denpasar tahun 2016

Radang pada usus buntu merupakan peradangan dari apendiks vermiformis. Pasien pasca operasi radang usus buntu yang ditangani dengan bedah terbuka atau laparoskopi akan merasakan suatu sensasi nyeri dari tindakan pembedahan yang dilakukan. Tujuan: Mengetahui gambaran evaluasi tingkat nyeri secara umum dan berdasarkan karakteristik data sampel. Metode: Penelitian ini menggunakan desain retrospektif observasional. Sampel ialah pasien pasca operasi radang usus buntu dengan bedah terbuka dan laparoskopi di Rumah Sakit Umum Pusat Sanglah Denpasar dari tahun 2016 dari hari pertama hingga hari ketiga pasca operasi. Pengambilan data menggunakan data sekunder, meliputi: skor VAS (visual analog scale) yang telah tertera pada rekam medis pasien. Tingkat nyeri dilihat dari hari pertama hingga hari ketiga pasien pasca operasi radang usus buntu dengan bedah terbuka dan laparoskopi. Hasil: Terdapat sebanyak 44 orang pasien bedah terbuka memberikan gambaran tingkat nyeri yang terdata pada hari pertama 75% nyeri ringan dan 25% nyeri sedang, hari kedua 2,3% tanpa nyeri, 86,4% nyeri sedang, dan 11,4 nyeri berat, serta pada hari ketiga 9,1% tanpa nyeri, 88,6 nyeri ringan, 2,3% nyeri sedang. Terdapat pula 6 orang pasien dengan laparoskopi yang terdata pada hari pertama 50% tanpa nyeri dan  50% nyeri ringan, pada hari kedua 66,7% tanpa nyeri dan 33,3% nyeri ringan, serta pada hari ketiga 83,3% tanpa nyeri dan 16,7% nyeri ringan. Simpulan: Gambaran evaluasi tingkat nyeri pasien pasca operasi radang usus buntu dengan bedah terbuka adalah nyeri ringan, sedangkan untuk laparoskopi adalah tanpa nyeri. 

The relationship between the decrease in Glomerulus Filtration Rate (GFR) and the increase in amount of coronary artery lesions on coronary heart disease patients in Sanglah General Hospital, Denpasar-Indonesia

Coronary heart disease or coronary artery disease is caused by the atherosclerosis process in the coronary blood vessels. The high number of patients with this condition is significantly due to the influence of modern and all instant lifestyle. Among the factors suspected to be capable of influencing the increase in the number of coronary artery lesions in coronary heart patients is the Glomerulus Filtration Rate (GFR). This result is related to the high mortality and morbidity of coronary heart patients. Aim: The purpose of this research is to determine the relationship between the decrease in glomerulus filtration rate (GFR), the disturbance variables (age, gender, hypertension history, diabetes mellitus history, smoking history) and the increase in the number of coronary artery lesions in Sanglah General Hospital. Methods: This research is an analytical observational design with the cross-sectional design using secondary data from the medical records in Sanglah General Hospital Denpasar. This study attains 196 sample. Results: A significant relationship is attained between GFR (<60 ml/ minute) and the increase in the total vessel score (p = 0.017) with an OR 2.47 (CI95% 1.014-6.041). Furthermore, there is a significant relationship between risky age (male >45, female >55) and the increase in total vessel score (p = 0.015) with an OR 3.54 (CI 95% 1.217-10.307). Diabetes mellitus and the increase in the total vessel score also shows a significant relationship  (p = 0.016) with an OR 2.99 (CI 95% 1.189-7.539). While other risk factors such as gender, hypertension, and smoking have an insignificant relationship (p > 0.05). In the multivariate analysis, GFR (<60 ml/ minute) is a predictor of the vessel score (p=0,050) with an adjusted value of OR 1.86 (CI 95% 0.735-4.725). There are some other variables in which are significant predictors of the increase in vessel score. Risky age (male >45, female >55) (p=0,048) with an adjusted OR value of 3.08 (CI 95% 1.012- 9.407) and also diabetes mellitus (p=0.044) with an adjusted OR value of 2.65 (CI 95% 0.145-0.973) are those predictors. Conclusion: Hence, it appears that GFR (<60 ml/ minute), risky age (male >45, female >55) and diabetes mellitus have a significant relationship with the increase in vessel score and are predictors of the increase in vessel score. While gender, hypertension, and smoking do not have significant relationships with the increase in the amount of vessel score.

Management of dentoalveolar fracture by using rigid wire and composite splint: A case report

Introduction: Dentoalveolar fractures in adults often occur in the context of daily activities and traffic accidents. Crown fracture is the most common type of lesion, followed by tooth mobility.

Case: A 67-year-old woman came to the Emergency Department with bleeding from the mouth because she fells down and her lips hit the bathroom floor. There was no history of unconsciousness, vomiting, and bleeding from ear and nose. The extraoral examination found an asymmetrical face, hematoma on the right eye area, nasolabial region and chin. Edema and hematoma on the upper and lower lip. The intraoral examination was found generalized hyperemia gingiva. The diagnosis was dentoalveolar fracture 12, 22 with crown fracture of teeth 11, 21, 22 accompanied by mobility grade 2 of 12, 11. First treatments are wound debridement, splinting with rigid wire and composite splint, and selective grinding. Panoramic references and prescribing antibiotics and analgesics. Post-action instructions include maintaining oral hygiene, soft diet, radices removal, and return for splinting control. Treatment results show good soft and hard tissue healing.

Conclusion: Rigid wire and composite splint are one of the most common and easy fixation techniques to treat dentoalveolar fractures. Simple tools and techniques make rigid wire and composite splint a good treatment for simple dentoalveolar fractures.

The accuracy of automated oscillometry compared to manual doppler in measuring ankle brachial index in suspected peripheral arterial disease patients: a systematic review

Background: Golden standard to diagnose Peripheral Artery Disease (PAD) is angiography. A more common and practical alternative technique is by calculating Ankle Brachial Index (ABI) using Oscillometry as systolic blood pressure measurement. Though, its accuracy remains obscure.

Methods: A systematic search was performed using PubMed and Google Scholar database.  There were 11 articles were found after reviewed for the title and abstract by inclusion and exclusion criteria. However, only 6 articles were relevant and used by the authors.

Results: Based on the six journals appraised, the sensitivity of automated oscillometry in detecting PAD (ABI <0.9) ranged from 0.4-0.7. The specificity, however, showed better result around 0.75-1. It shows that those patients who scored negative for PAD with oscillometry are not likely to have the disease. Automated oscillometry in studies appraised was also seen to have moderate positive and negative predictive value, which may indicate the possibility of this simpler diagnostic tool to be used to screen PAD. Most of the studies demonstrated good likelihood ratio for oscillometry, which even adds more power to oscillometry as a PAD diagnostic tool.

Conclusion: Automated oscillometry was comparable with manual Doppler due to its high specificity. Several advantages were identified such as; oscillometry required less reliant on the specialized skills, commonly available, reliable, and simple to use which can be performed by primary care physicians even in their primitive set up. Thus, the oscillometric method can be utilized as an alternative in diagnosing patients suspected with PAD.

Laporan Kasus: Perimortem Sectio Caesarean pada Ibu Hamil dengan Henti Jantung

Background Perimortem caesarean section (PMCS) was done in pregnant women with no hope for survival, and not responding to initial resuscitative maneuver. The primary aim of PMCS procedure is to empty the uterus to aid maternal resuscitation.

Case Presentation We performed a PMCS after no response of cardiopulmonary resuscitation (CPR) in a 19 years old woman with severe preeclampsia, severe anemia, and acute lung edema.

ConclusionThis is a case report of PMSC procedure performed in maternal cardiac arrest. The PMCS was done after no response of CPR with left uterine displacement (LUD). However, the outcome of maternal and neonatal deaths was unavoidable.